经导管主动脉瓣置换围术期Impella辅助救治主动脉瓣反流一例  

A case report of Impella-assisted treatment for severe aortic regurgitation during the perioperative period of transcatheter aortic valve replacement

作　　者：李华俊 刘先宝[1] 孔敏坚[2] 高峰[1] 王力涵[1] 林心平 胡颖红[3] 蒋峻[1] 蒲朝霞[1] 赵静 周琦晶[5] 温春杰[6] 王建安[1] Li Huajun;Liu Xianbao;Kong Minjian;Gao Feng;Wang Lihan;Lin Xinping;Hu Yinghong;Jiang Jun;Pu Zhaoxia;Zhao Jing;Zhou Qijing;Wen Chunjie;Wang Jian′an(Department of Cardiology,Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Cardiac Surgery,Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Intensive Care Unit,Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou;Department of Anesthesiology,Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Radiology,Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Cardiovascular Intervention Center,Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院心血管内科,杭州310009 [2]浙江大学医学院附属第二医院心脏大血管外科,杭州310009 [3]浙江大学医学院附属第二医院重症监护室,杭州310009 [4]浙江大学医学院附属第二医院麻醉科,杭州310009 [5]浙江大学医学院附属第二医院放射科,杭州310009 [6]浙江大学医学院附属第二医院心血管介入中心,杭州310009

出　　处：《中华心血管病杂志》2021年第2期179-181,共3页Chinese Journal of Cardiology

摘　　要：心原性休克是经导管主动脉瓣膜置换(TAVR)围术期严重急性并发症之一,体外膜肺氧合(ECMO)及左心辅助装置Impella等机械辅助装置为其重要救治手段。该文报道1例主动脉瓣重度关闭不全患者,在行经心尖途径TAVR过程中出现心跳骤停,立即予心肺复苏并及时置入人工瓣膜,患者循环未恢复,遂进行体外循环,ECMO辅助下返回病房,但患者心功能改善不明显,后置入Impella。患者逐渐好转,康复出院,术后1、3个月随访恢复良好。与ECMO相比,Impella可直接降低左心室的负荷,有助于瓣膜病合并循环障碍患者的心功能恢复。

关 键 词：主动脉瓣关闭不全 经导管主动脉瓣置换术 体外膜肺氧合 IMPELLA 

分 类 号：R654.2[医药卫生—外科学]